INSULIN DRUGS (insulin analogues)

Question 1

RAPID-acting: (drug names)

Answer 1

1. aspart
2. lispro
3. glulisine

Question 2

SHORT-acting: (drug name)

Answer 2

1. regular insulin

Question 3

INTERMEDIATE: (drug name)

Answer 3

1. NPH (neutral protamine Hagedorn = isophane insulin)

Question 4

LONG-acting: (drug names)

Answer 4

1. glargine

2. detemir

Question 5

GENERAL mechanism of action:

Answer 5

1. replace absent insulin secretion in DM1 or to supplement insufficient secretion in DM2
2. short-term treatment → required in patients with DM2 or impaired glucose tolerance during intercurrent events (infections, MI, pregnancy, major operations)
3. EMERGENCY treatment of hyperkalemia (insulin + glucose to lower hyperkalemia)

Question 6

GENERAL side effects:

Answer 6

1. hypoglycemia
2. weight gain
3. local injection site reactions
4. lipodystrophy
5. hypertrophy
6. REDUCE the dose in renal insufficiency

Question 7

mechanism of action → rapid- & short-acting insulin:

Answer 7

1. mimics the prandial release (in connection to food-intake) of insulin & to control postprandial glucose in conjugation with a LONG-acting basal insulin
2. usually combined with LONG-acting to maintain basal insulin level

Question 8

onset, peak & duration times of RAPID-acting insulin:

Answer 8

1. onset → 5min
2. peak → 1-1.5h
3. duration → 3-5h

Question 9

onset, peak & duration times of SHORT-acting insulin:

Answer 9

1. onset → 30min
2. peak → 2.5h
3. duration → 4-6h

Question 10

onset, peak & duration times of INTERMEDIATE insulin:

Answer 10

1. onset → 0.5-1h
2. peak → 8h
3. duration → 10-16h

Question 11

onset, peak & duration times of LONG-acting insulin:

Answer 11

1. onset → 2-4h
2. peak → NO peak
3. duration → 24h

Question 12

pre-mixed combinations of human insulin:

Answer 12

1. 70% NPH + 30% regular insulin
2. 50% of each

this decrease number of injections needed but makes it more difficult to adjust individual components of the insulin regimen